The CDC Chipotle E. coli Spat and the Public’s Right to Know, Sometimes

Chipotle’s beef with the CDC’s coverage of its 2015 E. coli outbreaks made headlines this week when letters exchanged between the two were made public. While the bandwagon touting the CDC as a champion of the public’s right to know got pretty crowded in the last couple of days, the bottom line is this: yes, the public does have a right to know, but usually it is never told.

By the CDC’s own admission, only a fraction of the outbreaks it investigates are made public. On average, it announces 10 multistate outbreaks a year. And it’s not really clear how the outbreaks on the CDC’s “list of selected outbreak investigations” are selected. Some have four case patients others have four hundred. Some occur in two states, others occur in more than 40 states. Some have information about the food source, some don’t. Some have the name of a restaurant involved, some say restaurants are involved but don’t name them and some provide only a description of the restaurant such as “Mexican-style fast food restaurant chain Restaurant Chain A” or “sandwich shop chain.” Some reports are published after the outbreak is over, some while it is ongoing.

Reports on some multistate outbreaks linked to restaurants are never made public by the CDC. A 2015 Salmonella outbreak linked to Fig & Olive restaurants sickened 175 people from six states. After the CDC took the lead on the investigation, it published nothing about the outbreak.

On March 16, 2016, one day after Food Poisoning Bulletin broke the story of a mulistate E. coli outbreak linked to Pizza Ranch restaurants that sickened 13 people in nine states between December 2015 and February 2016, the CDC released a statement saying only that the outbreak was over as the last reported case was February 9, 2016. Because it never issued a report, we don’t know when the CDC learned of the outbreak. We do know that two young children developed HUS, a life-threatening complication of E.coli infections and were hospitalized. And that the outbreak was linked to contaminated dough used to make dessert pizzas, not a typical vehicle for E.coli, so the CDC could have used that as a teaching moment. But it did not.

All of that is not to say that the folks at the CDC and the FDA aren’t working hard everyday to try to keep the public safe. Countless state and local public health officials are too. But there is a lot of food poisoning going on out there and the public has no idea about most of it.

So, what happened with Chipotle?

Letters exchanged between Chipotle and CDC in December 2015 were published online this week and Reuters reported on them. (You can read the letters here and here.) To be clear, the argument is not, as some have reported, that Chipotle did not want the the public to know about the outbreak. Instead, the company takes issue with the the language and timing of some of the agency’s reports.

“While the initial announcement and early updates were generally necessary and appropriate, the ongoing updates were not useful and did not serve to inform the public of a significant health risk. Rather, these updates misrepresented the E. coli O26 outbreak as ongoing and unnecessarily intensified the public’s concern,” the letter from Chipotle’s lawyers states.For example, the last illness was reported December 1, 2015, but the CDC issued three reports after that and did not issue a final report stating the outbreak was over until February 1, 2016. (See Pizza Ranch timing above.) And some of the people who were sickened by the outbreak strain of E. coli O26 did not eat at Chipotle, according to the CDC, yet their states are included in the outbreak reporting.

Genetic testing was used to identify 36 of the 55 cases in this outbreak and four of the cases reported in the second outbreak. The CDC says 47 of 52 patients interviewed reported eating at Chipotle before they became ill. That all 52 cases are attributed to the “Chipotle E. coli outbreak” even though not all did not say they ate Chipotle food is not different than the way the CDC has reported other outbreaks.

The exact number of people who ate food and got sick from it is important to every company involved in a food poisoning outbreak. Chipotle is not different than others on that score. But the biggest, most important question is not whether it was a nine-state outbreak or a seven-state outbreak; it’s what was the contaminated food source?

More than 2,500 tests were performed on Chipotle food, restaurant surfaces and equipment and none was positive for E.coli, according to the U.S. Food and Drug Administration (FDA). Yet no traceback investigation provided a clue?

What food distributors of affected Chipotle restaurants were involved? And did they also do business in the states where people were sickened by the same E. coli strain but did not eat at Chipotle?